Glucose variability and mood in people with type 1 diabetes using ecological momentary assessment.
Level 4 - case-series / case-control
Prospective observational study without a control group
PubMed 37643560 · doi:10.1016/j.jpsychores.2023.111477
What was done
Eighteen adults with type 1 diabetes (10 female, mean age 44.3 years) wore a masked continuous glucose monitor and answered smartphone-based ecological momentary assessment prompts 6 times per day for 14 days assessing mood dimensions (anxiety, depressive symptoms, anger, fatigue, vigor) via the Profile Of Mood States Short Form. Mixed model analyses examined associations between daily blood glucose coefficient of variation (CV) and daily mean and variability of mood scores, exploring sleep and nocturnal hypoglycemia as moderators.
What was found
Across 18 participants, 264 of 367 monitored days (70.2%) were analyzed. No overall significant associations were detected between daily blood glucose CV and mean or CV of mood scores. Nocturnal hypoglycemia moderated the relationship between blood glucose CV and mood scales: mean Fatigue (estimate 1.998, p < .006), mean Vigor (estimate -3.308, p < .001), Anger CV (estimate 0.731, p = 0.02), and Vigor CV (estimate -0.525, p = .006).
Why it matters
This study suggests that overall daily glycemic variability alone does not directly correlate with daily mood fluctuations in adults with type 1 diabetes, highlighting nocturnal hypoglycemia as an important moderating factor.
Limits
The sample size was very small (n = 18), nearly 30% of observation days were excluded due to missing data, the observational period was limited to 14 days, and the study lacked a non-diabetic or control comparator group.
Cited by
- context Large glucose peaks and valleys lead to brain fog, fatigue, irritability, and hunger.